Molecular Targets and Clinical Cancer Risk Reductive Interventions

Publisher Summary The term chemoprevention was first used by Sporn et al . to define the use of interventions ranging from diet modification, purified dietary extracts, to drugs for the purpose of blocking, reversing, or preventing the development of invasive cancer. The term “cancer risk reductive intervention” (CRRI) is preferred over the term “chemoprevention” to precisely identify the broad range of strategies to reverse or delay carcinogenesis, including whole diet interventions, dietary extracts, drugs, behavior modification, smoking cessation, and others. The carcinogenesis process occurs over decades and provides opportunities to intervene at many steps in transformation and cancer initiation. As the carcinogenesis process requires a cascade of molecular changes over time, the interventions designed to reverse or delay these changes need to be diverse and target multiple mechanisms of carcinogenesis. In the development and clinical deployment of CRRIs, one must be mindful of therapeutic index, the toxicity, or side effects of a given intervention compared to the benefit derived from that intervention. CRRIs are intended for use in healthy individuals who have increased the risk of developing cancer due to genetic predisposition or environmental exposures or both. Successful deployment of CRRIs will reduce cancer-associated mortality or delay the age of mortality.